Taking care of your surgical wounds aids your recovery. Swelling is normal after surgery and bruising is not uncommon.
Cold packs are a widespread method to prevent and or reduce post operative swelling. Heat packs are often used for comfort and to reduce bruising.
Do cold and heat packs really work?
Yes and no. It depends on how you look at it.
Both hot and cold therapy packs can help you recover from a surgery procedure. How they exactly help may have more to do with having an active role in your recovery and being able to reduce discomfort than a direct effect from the cold and heat.
This because there are no well-designed studies confirming the claims that cold and heat reduce swelling and bruising.
One PubMed study examining the effects of cold therapy on pain, swelling and range of motion after surgery concluded:
“There was no difference between groups with respect to hospital stay, pain medication use, pain scale, knee girth, or range of motion.” Source: PubMed.
While another study did seem to promise some scientific evidence for their effectiveness however, this study was done on dogs.
Cold compression therapy decreased signs of pain, swelling, and lameness and increased stifle joint range of motion in dogs during the first 24 hours after surgery. Source: PubMed.
Yet still, as mentioned before, being able to take care of yourself after you have given everything out of hand is a good thing. You may be dealing with pain, itch, stiffness, boredom, and other discomfort so everything you can do will make a difference.
On top of that, they are both non-invasive and non-addictive pain-relief therapies.
How are they supposed to work?
Cryotherapy, the therapeutic use of ice or cold lowers the temperature of the injured tissue, constricting blood vessels, reducing blood flow and the tissue’s metabolic rate. Supposedly decreasing inflammation and swelling and helping it survive the period following the injury.
Heat opens up blood vessels stimulating blood flow in the area. By dilating the veins and lyphatics heat is said to clear the blood that caused bruising and the fluid that caused swelling. This leads to increased oxygen and nutrients supply thus reducing pain, increasing motion and promoting healing.
How to use cold and heat packs after surgery?
- A typical household method is to use a bag of frozen peas. Although this works a gel pack is a more efficient and convenient method since it does not leak and molds to the contours of your body. Thus increasing the impact of the pack while reducing potentially damaging pressure on the surgical wound site.
- It is often advised to apply ice or cold packs to injured areas for no more than 20 minutes at a time, waiting for 10 minutes before reapplying.
- Some surgeons also recommend to not apply cold or heat for 24 hours after the first 48 hours of application. Ask your surgeon what he or she recommends for your particular procedure.
- Some surgeons recommend to apply cold and warm soaks instead of compresses because they are more gentle. Involving less risk on burning or frost damaging the already delicate location.
- Another more gentle method is to place the ice pack or pad in a lean towel or washcloth thus avoiding direct contact with the wound.
- Don’t use heat on an open wound or stitches.
When to use cool or cold compresses and when to use heat packs?
In general, cold packs are used in the first stage after the procedure (first few days) and later on heat packs are applied. This is the general consencus among surgeons and medical practitioners.
Depending on the type of surgery this first cold therapy period can vary from 1 day to up to 4 days or more. Sometimes there are advantages of switching to warm compresses after those first days of cold therapy.
A popular and natural dietary supplement that helps reduce post surgery swelling is bromelain.
The differences between cold and heat packs
In order to treat the area you are operated on best it is helpful to understand what cold and heat packs exactly do.
Both are theorized to help reduce inflammation which is a normal process in wound healing. Keeping it at bay is often recommended though.
- reduce swelling
- relieve pain by numbing the nerves in the affected area
- gentle pressure with a cool compress is used in case of light bleeding
- reduce bruising
- soften early scar tissue
- reduce joint and muscle stiffness
- increase blood flow in the affected area
Most surgeons recommend cold gel packs. They are easily chilled by placing them in the freezer for 10 to 20 minutes. Here’s a very popular cold pack that is well-reviewed on Amazon.
Cold Compression Therapy combines two of the principles of R.I.C.E. (Rest, Ice, Compression, Elevation) to reduce pain and swelling and is often recommended by orthopedic surgeons following surgery.
Heat packs are known to help reduce discomfort and bruising. Used to keep body parts warm they provide therapy or comfort by relaxing muscles and reducing pain.
In general you can start using them about 3 to 4 days after surgery but you should consult with your doctor or surgeon to be sure.
There are different types of heating hot packs.
- hot (heating) pads
- warm compress
- gel packs
- rice and wheat filled heat wraps
- a hot water bottle
Pros and cons of different types of heat packs
A heating pad is the safest and most effective way to deliver heat to a post-surgical body part. Temperatures remain constant as long as the unit is plugged in. Temperature ranges can often be adjusted with settings. Temperatures never get so high that you can burn your skin or underlying tissue.
Warm compresses can be as simple as an in warm water soaked washcloth or towel. These are also commonly recommeded by surgeons because they deliver moist heat into the affected tissue.
Apart from cleaning up some of the wound matter, antibiotic ointment residu and the “scabby” look to the incisions there is another benefit of wet warm compresses. In general, wounds that are kept moist heal faster.
Downside, a warm compress loses heat quickly and needs to be reheated every few minutes.
Gel packs are plastic, gel-filled pouches that are heated by microwave . Require reheating about every half hour.
Here’s Amazon’s most popular heat pad.
Risks and side effects
Don’t over do the cool packs
Too much of a good thing is never enough isn’t the case here. There are people who suffered from frostbite due to over use of cold packs. Especially when the skin is numb after a procedure frostbite may occur.
Also an allergic reaction to post surgery cold therapy called cold urticaria has been reported.
Be careful with heat packs
A 41-year-old woman accidentally burned her breast with a heat pack. While at home, one month after her mastectomy and inplant reconstruction procedure the woman applied microwave heated ‘wheat sack’ for 15 minutes to her breast.
At the moment she felt no pain but an hour later she noticed blistering on her breast. The reason that she didn’t notice the heat pack had been too had to do with two things.
Reduced protective sensation, common after surgery increases the risk on burn wounds due to heat packs. In this particular surgery the thinner, less vascular overlying skin was also more vulnerable causing it to burn sooner.
In other words, thinner skin, less fat and vains and loss of sensitivity made the area more susceptible to (self-inflicted) thermal injury. Source: Journal of the Royal Society of Medicine.
Wrapping it up
There is no hard, cold evidence based on well-designed double controlled blind studies that proofs hot and cold therapy help you heal faster after surgery.
However, anecdotal reports are abundant and the practice is so widespread that there must be something to it. Anyway, being proactive regarding your recovery is a good thing. So are being able to increase your comfort. In the end these aspects all contribute to a more positive attitude.
Always consult your surgeon or doctor about your best personal approach.